• Other systems in East of England health economy have been asked to help out Cambridge and Peterborough STP
  • Is understood which local budgets will be affected is yet to be finalised
  • County council in region says agreement ”seems unfair”

Concern has been raised about what the impact on budgets will be of NHS England calling on health systems in the East of England to divert funding to address severe financial pressures in Cambridgeshire and Peterborough.

The three sustainability and transformation partnerships and two integrated care systems in the region have been asked by NHS England to provide £5m each to Cambridgeshire and Peterborough STP

LGC has now reported this has prompted fears that funding, such as the element of the better care fund distributed to councils for adult social care, could be reduced as budgets are reconfigured to cover the money diverted away from local systems.

report to the Cambridgeshire and Peterborough STP board in July said the system is planning to overspend by £192m in 2019-20. This financial position means as a whole the East of England region – which includes Suffolk and North East Essex, and Bedfordshire, Luton and Milton Keynes ICSs, and Herts and West Essex, Mid and South Essex, and Norfolk and Waveney STPs – is £50m away from a control total cap on expenditure imposed by NHSE.

NHSE said all systems in the region have agreed to divert the funding, but LGC understands decisions on which local budgets will be affected are yet to be finalised in some areas.

report to the Suffolk and North East Essex ICS board in April said it was “not minded to risk” its financial position if a directive was issued for STPs to bridge Cambridge and Peterborough’s funding gap.

Suffolk County Council’s cabinet member for adult care Beccy Hopfenspurger told LGC, while the full impact of the movement of funding away from her local area was unknown, it “seems unfair” the local system could lose funding, particularly when there is ongoing uncertainty over the better care fund next year.

“We pool money but, if it is money that we have to give that doesn’t benefit the Suffolk system, it is money that is being taken away from us,” she said.

“We have pushed as a system to arrange strong financial controls both in acute, [clinical commissioning groups] and local government and we have to suffer from that system that hasn’t managed its finances as well as we have.”

Ms Hopfenspurger said clinical commissioning groups often support smaller projects that fail to attract funding from elsewhere and money being diverted could put them at risk.

“Our alliance works on social care and health integration; the CCG pool’s money that goes into that. This may well affect our ability to carry on with some of that work,” she added.

LGC understands there is strong resistance to releasing the funding within the Herts and West Essex STP due to the potential impact on budgets.

report to Norfolk’s health and wellbeing board in July said Norfolk and Waveney STP has agreed to provide the requested funds.

It said: “Further to previous discussions on the requested support to the Cambridgeshire and Peterborough STP, we have now agreed £5m support from our health system.

“This is non-recurrent, and we have been told that this is repayable in the next three years. Of this sum, £4m has been provided from our organisations and £1m support from NHSI/E to our system.”

Norfolk CCG declined to comment on the impact of this on social care funding.

Ann Radmore, East of England regional director for NHS England and NHS Improvement, said: “We expect every NHS organisation to live within their means, and the benefit of taking a joined-up regional approach is that we can tackle the issues together.

“All CCGs are required to make a minimum contribution to the better care fund and have committed to do so in 2019-20. The £5m contribution from STPs and ICSs in the East of England region should not impact on this requirement.”

NHSE/I in the East of England said it is developing “a programme across the region aimed at improving productivity and exploring opportunities to make greater efficiency savings”.

Cambridgeshire and Peterborough, and Mid and South Essex STPs, and Bedfordshire, Luton and Milton Keynes ICS have been contacted for comment.

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